Coronavirus cases surge in the US, unequal access drives down vaccination and treatment rates | Coronavirus

The coronavirus is surging across the U.S., with virus levels exceeding last summer's wave nationally and approaching the peak of last winter's wave in the West, wastewater agencies report. data From the US Centers for Disease Control and Prevention (CDC).

But vaccination and antiviral drug coverage remains low, plagued by unequal access, and resistance to other preventive measures such as mask-wearing is growing.

“We have a lot of people across the country right now who are infected with COVID-19,” said Dr. Peter Chin-Hong, a professor of medicine and infectious disease expert at the University of California, San Francisco. “We still have people hospitalized in the U.S., and hundreds of people dying every week. This is a tragedy.”

The rise in cases is being driven by three variants known as “Flirt” variants that share a common mutation that makes them more immune evasive and transmissible. Also, much of the US is experiencing a heat wave that has many Americans staying indoors to avoid the heat, which could lead to further spread of the virus.

Nationwide, emergency room visits due to COVID-19 15.7% Increased in the past week Hospitalization rate The rate is now higher than it was at this time last summer, but comparisons can be difficult to make because far fewer hospitals are required to report COVID-19 infection rates than in previous years.

Deaths have also been rising after reaching their lowest point in the pandemic: Nearly 400 people died in the week ending June 12, the last week for which complete case reporting was available. data It was available. 4th Causes of death in America.

“With the tools we have, hospitalizations and deaths are completely preventable,” Chin Hong said.

But compared to other outbreaks, “this feels like a very different time,” said David Grabowski, a health policy professor at Harvard Medical School, adding that “it's pretty unusual to go into a building and see people wearing masks” — even in hospitals and nursing homes.

Experts say the surge in cases this summer was due to some federal and state policies backing away from efforts that could have stopped the virus from spreading.

North Carolina recently enacted a law limit Authorities in New York City and Los Angeles have made wearing masks mandatory in public places. Considered same.

In May, the CDC relaxed its COVID-19 isolation guidelines, recommending that patients stay home until they've been fever-free and symptom-free for 24 hours, during which time they're likely still contagious even if they test positive for the virus.

The U.S. government once covered the cost of COVID-19 vaccines, but that payment shifted to the private market in 2023. A bridge program offering vaccines to the uninsured ends next month, just weeks before renewed boosters become available, likely worsening disparities in access to life-saving vaccines.

Only 22.5% of adults and 14.4% of children Latest COVID-19 vaccination rates are even lower among pregnant women (13.3%). Serious illness, complications and Long Corona Due to coronavirus infection during pregnancy.

There are also stark contrasts among Americans of color, where inequalities in access to health care continue to impact vaccination rates: While a quarter of white adults have been vaccinated, only 15.6% of Native Americans and 16.2% of Hispanic adults have received their latest booster shot.

Chin Hong said the disparities are “pretty stark” and especially concerning among seniors of color, who have been more at risk throughout the pandemic. “There's not been a lot of attention paid to making sure all seniors get vaccinated or understanding the power of the vaccine to keep people safe.”

Vaccination rates are high among seniors, who face the highest rates of hospitalization and death, but “the numbers are far too low,” Grabowski said. The third Percentage of nursing home residents who are up to date on COVID-19 vaccinations.

“These figures are really worrying. It's not clear that these residents will have the same protections they had earlier in the pandemic,” he said.

“I think there's a lot of fatigue around this issue in nursing homes, both among staff and residents,” Grabowski said. I have written He recently spoke about the reforms that need to be made to make nursing homes safer in the wake of the pandemic: “I don't think there's the same caution now that we saw early on in the pandemic.”

Antiviral drugs like paxlovir have similarly experienced unequal uptake: People of color are significantly less likely to be prescribed paxlovir than white patients, about 20% to 36% less likely, according to one study. study30% to 36%. another.

Only 15% of patients at high risk of severe illness are taking paxlobriand, one preprint paper said. study It suggests this despite evidence that it helps reduce the worst outcomes, including death, among vulnerable people.

“It seems like we're not really directing resources to the most vulnerable, and that's really unfortunate,” Grabowski said. “That's a real red flag.”

The CDC recently explanation While viruses such as influenza and respiratory syncytial virus tend to peak in the winter, the new coronavirus can spike at any time of the year, including summer.

The agency recommended that everyone 6 months of age or older get a renewal booster shot in the fall, and everyone 65 and older get a booster shot at least four months later.

Chin-Hong hopes vaccination rates will rise again this fall when a new booster vaccine becomes available. He also hopes public attitudes will change so that the COVID-19 vaccine is viewed as routine, like a flu shot. “Hopefully, in 2025 we'll have a combination flu-COVID vaccine,” he said. “Then it might be more acceptable to people.”

As the virus continues to spread, Grabowski said measures beyond vaccines and treatments will also help curb its spread, especially in high-risk settings like nursing homes.

“Other measures need to be put in place, such as testing, personal protective equipment and improved air quality,” Grabowski said. But change has been slow, and some of the gains made during the pandemic now appear to be reversing, Grabowski said.

“There was some planning in place early on in the pandemic, and now I think that's completely gone.”